How do I best incorporate feedback into my practice?

3.4: Identify one’s own strengths, weaknesses, and limits; a) seek and respond appropriately to performance feedback, b) maintain an appropriate balance of personal and professional commitments, and c) seek help and advice when needed.

During the first part of my third year, I was dealing with anxiety that I had struggled with starting in second year. This affected some of my first rotations negatively, as it started to manifest as imposter syndrome. It was scary to walk into rooms and essentially pretend to be a doctor. I knew it was necessary practice, but it was hard to push through feelings of inadequacy. I would freeze up, and it was like I could not access all the knowledge that I had worked so hard to build up over first and second year. This clearly translated into my evaluations at the time.

At the time, I considered it to be more of an academic failing, which I can see in my portfolio writing from that time.

I think this was at least partially true, as I was still revising my study habits at the time, after a rough second year inspired me to change them. That information would probably be easier to recall if I had felt more comfortable with it in the first place. But I have reflected a lot about this time in the years since then, and I think that my biggest problem was that imposter syndrome. I struggled with it in following rotations, although never quite as badly as I did during my family medicine rotation that summer, which I had to remediate. During the mid-rotation feedback session for that rotation, one of my preceptors told me something that has stuck with me: “The buck stops with me right now, but pretty soon its going to stop with you. Its ok to be worried about not doing the right thing, the important thing is using all your resources to figure it out.”

I wrote that I went home that weekend and studied hard and did a bunch of things to try and put me on a better footing for the rest of the rotation, but what was more important in the long term is how that moment changed how I approached rotations and medicine in general. I wanted to appear like I knew everything I expected an attending to want me to know at all times, and whenever there I did not know what to do next I would freeze up. This interacted with the stutter I have dealt with my entire life, so I would then stammer through presentations and offer a half-hearted thought process for a plan.  After that, I prepared more extensively for rotations, if I did not know what to do in a patient room, I would take my time and be more thorough, and I practiced my presentations to get them to flow better. After working on my baseline, I worked to get more comfortable with showing my true baseline, rather than clamming up if I did not produce a perfect assessment and plan. The feedback I received from that attending, and what I did afterwards ultimately made me a better physician and paved the way for the success that I’ve had during the rest of medical school. Since then, I have really tried to seek out feedback much more aggressively and incorporate it into my practice. I want to continue to do this in residency, and it is my goal to sit down with attendings whenever possible so that I can be the best doctor possible for my patients.

 

Goals:

  • Sit down with attendings at least once a week for a longer feedback session, ask for this if not offered.
  • Ask for some quick feedback after each shift
  • Ask residency classmates what has worked for them, or if they notice things that I need to work on.

 

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